早期肠道营养可能与心脏骤停中改善的生存结果有关
Jingwei Duan1, Jianjie Ren1, Xiaodan Li1
1Emergency Department, Peking University Third Hospital, Beijing, China.
Emergency medicine international
|July 4, 2024
概括
在心脏骤停 (CA) 后的48小时内,早期肠道营养 (EN) 与更好的生存率和较少的并发症 (如腹) 有关. 这项研究表明,早期EN是CA患者有益的食策略.
科学领域:
- 关键护理医学 关键护理医学
- 营养支持营养支持
- 心脏病学 心脏病学
背景情况:
- 目前的指导方针提倡在重症患者中早期进行肠道营养 (EN).
- 由于独特的病理生理学,对心脏骤停 (CA) 后患者的最佳养策略存在有限的研究.
- 其他疾病的EN证据对CA患者的适用性是不确定的.
研究的目的:
- 调查肠道营养 (EN) 开始时间 (48小时内 vs. 48小时后) 与心脏骤停 (CA) 后患者的临床结果之间的关联.
- 在这个患者群体中评估早期EN的安全性.
主要方法:
- 使用MIMIC-IV (版本2.2) 数据库进行的回顾性队列研究.
- 1:1倾向分数匹配 (PSM) 用于在早期和延迟EN组之间平衡基线特征.
- 用调整的比例危险模型来控制医院前和住院因素,验证早期EN与结果相关性的独立性.
主要成果:
- 在PSM之后,分析了670名患者. 早期的EN启动 (48小时内) 与CA后30,90和180天的显著改善的生存结果有关 (HR=0.779,p=0.041).
- 两组之间在30天的神经结果中没有显著差异 (OR=0.786,p=0.070).
- 与延迟EN组相比,接受早期EN的患者患有较低的内脏风险 (OR=0.461,p=0.016) 和较短的住院时间.
结论:
- 早期肠道营养 (EN) 可能与心脏骤停 (CA) 康复的患者的改善生存结果有关.
- 虽然神经学结果没有显示出显著的差异,但早期的EN显示出阴茎和住院时间的减少.
- 需要进一步的研究,但目前的发现表明,早期的EN可能是后CA患者更适合的营养策略.
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